中医辨证联合沙利度胺片治疗肝癌的临床研究  

Clinical Research of Syndrome-differentiation Treatment Combined with Thalidomide Tablets for Hepatocellular Carcinoma

作　　者：林靖[1] 周岱翰[2] 

机构地区：[1]广州中医药大学,广东广州510405 [2]广州中医药大学第一附属医院肿瘤科,广东广州510405

出　　处：《广州中医药大学学报》2016年第4期449-452,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81173161);广东省中医药管理局科研课题(编号:20141085)

摘　　要：【目的】观察中医辨证联合沙利度胺片治疗肝癌的临床疗效。【方法】将80例原发性肝癌患者按3∶1比例随机分为治疗组60例与对照组20例,其中治疗组60例按中医辨证分型分为肝热血瘀型(22例)、肝盛脾虚型(21例)、气阴两虚型(17例)3组。治疗组在辨证基础上服用中药汤剂联合沙利度胺片治疗,对照组给予沙利度胺片治疗,疗程3个月。观察各组患者的Child-Pugh分级、甲胎蛋白(AFP)水平、Karnofsky评分及中医证候积分的变化情况,并评价其安全性。【结果】(1)治疗后,肝热血瘀组、肝盛脾虚组、气阴两虚组患者的中医证候积分及Karnofsky评分改善均优于治疗前及对照组(P<0.05或P<0.01)。(2)治疗后,肝热血瘀型及肝盛脾虚型患者的AFP水平有所下降(P<0.01),Child-Pugh分级有所改善(P<0.05),且其改善作用均优于对照组(P<0.05或P<0.01)。(3)治疗过程中,除2例患者(治疗组和对照组各1例)出现短暂便秘反应外,其余未见有不良反应事件发生。【结论】中医辨证联合沙利度胺片治疗肝癌有效,在改善肝癌患者中医证候积分、生活质量、肝功能以及稳定肿瘤细胞方面有一定优势。Objective To observe the therapeutic effect of syndrome-differentiation treatment combined with thalidomide tablets for patients with hepatocellular carcinoma. Methods A total of 80 patients with hepatocellular carcinoma were randomly divided into treatment group （60 cases） and control group （20 cases）. The patients in the treatment group were differentiated into liver excess heat with blood stasis （22 cases） , liver-qi hyperactivity inducing spleen deficiency （21 cases）, and qi-yin deficiency （17 cases）. Treatment group was given syndrome-differentiation treatment combined with thalidomide tablets, and the control group was given thalidomide tablets alone. The treatment for the two groups lasted for 3 months. Clinical outcomes included Child-Pugh grading, alpha fetal protein （AFP）, Karnofsky performance status （ KPS ） scores, and traditional Chinese medical syndrome scores. The safety of the treatment was also observed. Results （l）The treatment group could improve the traditional Chinese medical syndrome scores and KPS scores, which were significantly different from those before treatment and from the control group after treatment （P〈0.05 or P〈0.01 ）. （2）After treatment, AFP level was decreased（P〈O.01） and Child- treatment group with the syndromes of liver excess heat Pugh grading was improved（P〈0.05）in patients of the with blood stasis and liver-qi hyperactivity inducing spleen deficiency as compared with those before treatment. And the effects of the treatment group were superior to those of the control group （P〈0.05 or P〈0.01）. （3）During the treatment, only constipation occurred in one case from the treatment group and in one case from the control group, and no other reverse reaction was found. Conclusion Syndrome-differentiation treatment combined with thalidomide tablets is effective for the treatment of patients with hepatocetlular carcinoma, showing advantages in improving traditional Chinese medical syndrome scores, the quality of life a

关 键 词：辨证论治 肝热血瘀型 肝盛脾虚型 气阴两虚型 沙利度胺片 肝癌 

分 类 号：R735.7[医药卫生—肿瘤]